A de novo paradigm for male infertility.

De novo mutations are known to play a prominent role in sporadic disorders with reduced fitness. We hypothesize that de novo mutations play an important role in severe male infertility and explain a portion of the genetic causes of this understudied disorder. To test this hypothesis, we utilize trio-based exome sequencing in a cohort of 185 infertile males and their unaffected parents. Following a systematic analysis, 29 of 145 rare (MAF < 0.1%) protein-altering de novo mutations are classified as possibly causative of the male infertility phenotype. We observed a significant enrichment of loss-of-function de novo mutations in loss-of-function-intolerant genes (p-value = 1.00 × 10-5) in infertile men compared to controls. Additionally, we detected a significant increase in predicted pathogenic de novo missense mutations affecting missense-intolerant genes (p-value = 5.01 × 10-4) in contrast to predicted benign de novo mutations. One gene we identify, RBM5, is an essential regulator of male germ cell pre-mRNA splicing and has been previously implicated in male infertility in mice. In a follow-up study, 6 rare pathogenic missense mutations affecting this gene are observed in a cohort of 2,506 infertile patients, whilst we find no such mutations in a cohort of 5,784 fertile men (p-value = 0.03). Our results provide evidence for the role of de novo mutations in severe male infertility and point to new candidate genes affecting fertility.

Exome sequencing reveals variants in known and novel candidate genes for severe sperm motility disorders.

STUDY QUESTION: What are the causative genetic variants in patients with male infertility due to severe sperm motility disorders? SUMMARY ANSWER: We identified high confidence disease-causing variants in multiple genes previously associated with severe sperm motility disorders in 10 out of 21 patients (48%) and variants in novel candidate genes in seven additional patients (33%). WHAT IS KNOWN ALREADY: Severe sperm motility disorders are a form of male infertility characterised by immotile sperm often in combination with a spectrum of structural abnormalities of the sperm flagellum that do not affect viability. Currently, depending on the clinical sub-categorisation, up to 50% of causality in patients with severe sperm motility disorders can be explained by pathogenic variants in at least 22 genes. STUDY DESIGN, SIZE, DURATION: We performed exome sequencing in 21 patients with severe sperm motility disorders from two different clinics. PARTICIPANTS/MATERIALS, SETTING, METHOD: Two groups of infertile men, one from Argentina (n = 9) and one from Australia (n = 12), with clinically defined severe sperm motility disorders (motility <5%) and normal morphology values of 0-4%, were included. All patients in the Argentine cohort were diagnosed with DFS-MMAF, based on light and transmission electron microscopy. Sperm ultrastructural information was not available for the Australian cohort. Exome sequencing was performed in all 21 patients and variants with an allele frequency of <1% in the gnomAD population were prioritised and interpreted. MAIN RESULTS AND ROLE OF CHANCE: In 10 of 21 patients (48%), we identified pathogenic variants in known sperm assembly genes: CFAP43 (3 patients); CFAP44 (2 patients), CFAP58 (1 patient), QRICH2 (2 patients), DNAH1 (1 patient) and DNAH6 (1 patient). The diagnostic rate did not differ markedly between the Argentinian and the Australian cohort (55% and 42%, respectively). Furthermore, we identified patients with variants in the novel human candidate sperm motility genes: DNAH12, DRC1, MDC1, PACRG, SSPL2C and TPTE2. One patient presented with variants in four candidate genes and it remains unclear which variants were responsible for the severe sperm motility defect in this patient. LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: In this study, we described patients with either a homozygous or two heterozygous candidate pathogenic variants in genes linked to sperm motility disorders. Due to unavailability of parental DNA, we have not assessed the frequency of de novo or maternally inherited dominant variants and could not determine the parental origin of the mutations to establish in all cases that the mutations are present on both alleles. WIDER IMPLICATIONS OF THE FINDINGS: Our results confirm the likely causal role of variants in six known genes for sperm motility and we demonstrate that exome sequencing is an effective method to diagnose patients with severe sperm motility disorders (10/21 diagnosed; 48%). Furthermore, our analysis revealed six novel candidate genes for severe sperm motility disorders. Genome-wide sequencing of additional patient cohorts and re-analysis of exome data of currently unsolved cases may reveal additional variants in these novel candidate genes. STUDY FUNDING/COMPETING INTEREST(S): This project was supported in part by funding from the Australian National Health and Medical Research Council (APP1120356) to M.K.O.B., J.A.V. and R.I.M.L., The Netherlands Organisation for Scientific Research (918-15-667) to J.A.V., the Royal Society and Wolfson Foundation (WM160091) to J.A.V., as well as an Investigator Award in Science from the Wellcome Trust (209451) to J.A.V. and Grants from the National Research Council of Argentina (PIP 0900 and 4584) and ANPCyT (PICT 9591) to H.E.C. and a UUKi Rutherford Fund Fellowship awarded to B.J.H.

Fully implanted adaptive deep brain stimulation in freely moving essential tremor patients.

OBJECTIVE: Deep brain stimulation (DBS) is a safe and established treatment for essential tremor (ET) and several other movement disorders. One approach to improving DBS therapy is adaptive DBS (aDBS), in which stimulation parameters are modulated in real time based on biofeedback from either external or implanted sensors. Previously tested systems have fallen short of translational applicability due to the requirement for patients to continuously wear the necessary sensors or processing devices, as well as privacy and security concerns. APPROACH: We designed and implemented a translation-ready training data collection system for fully implanted aDBS. Two patients chronically implanted with electrocorticography strips over the hand portion of M1 and DBS probes in the ipsilateral ventral intermediate nucleus of the thalamus for treatment of ET were recruited for this study. Training was conducted using a translation-ready distributed training procedure, allowing a substantially higher degree of control over data collection than previous works. A linear classifier was trained using this system, biased towards activating stimulation in accordance with clinical considerations. MAIN RESULTS: The clinically relevant average false negative rate, defined as fraction of time during which stimulation dropped below [Formula: see text] clinical levels during movement epochs, was 0.036. Tremor suppression, calculated through analysis of gyroscope data, was 33.2% more effective on average with aDBS than with continuous DBS. During a period of free movement with aDBS, one patient reported a slight paresthesia; patients noticed no difference in treatment efficacy between systems. SIGNIFICANCE: Here is presented the first translation-ready training procedure for a fully embedded aDBS control system for MDs and one of the first examples of such a system in ET, adding to the consensus that fully implanted aDBS systems are sufficiently mature for broader deployment in treatment of movement disorders.

Exome sequencing reveals novel causes as well as new candidate genes for human globozoospermia.

STUDY QUESTION: Can exome sequencing identify new genetic causes of globozoospermia? SUMMARY ANSWER: Exome sequencing in 15 cases of unexplained globozoospermia revealed deleterious mutations in seven new genes, of which two have been validated as causing globozoospermia when knocked out in mouse models. WHAT IS KNOWN ALREADY: Globozoospermia is a rare form of male infertility characterised by round-headed sperm and malformation of the acrosome. Although pathogenic variants in DPY19L2 and SPATA16 are known causes of globozoospermia and explain up to 70% of all cases, genetic causality remains unexplained in the remaining patients. STUDY DESIGN, SIZE, DURATION: After pre-screening 16 men for mutations in known globozoospermia genes DPY19L2 and SPATA16, exome sequencing was performed in 15 males with globozoospermia or acrosomal hypoplasia of unknown aetiology. PARTICIPANTS/MATERIALS, SETTING, METHOD: Targeted next-generation sequencing and Sanger sequencing was performed for all 16 patients to screen for single-nucleotide variants and copy number variations in DPY19L2 and SPATA16. After exclusion of one patient with DPY19L2 mutations, we performed exome sequencing for the 15 remaining subjects. We prioritised recessive and X-linked protein-altering variants with an allele frequency of <0.5% in the population database GnomAD in genes with an enhanced expression in the testis. All identified candidate variants were confirmed in patients and, where possible, in family members using Sanger sequencing. Ultrastructural examination of semen from one of the patients allowed for a precise phenotypic characterisation of abnormal spermatozoa. MAIN RESULTS AND ROLE OF CHANCE: After prioritisation and validation, we identified possibly causative variants in eight of 15 patients investigated by exome sequencing. The analysis revealed homozygous nonsense mutations in ZPBP and CCDC62 in two unrelated patients, as well as rare missense mutations in C2CD6 (also known as ALS2CR11), CCIN, C7orf61 and DHNA17 and a frameshift mutation in GGN in six other patients. All variants identified through exome sequencing, except for the variants in DNAH17, were located in a region of homozygosity. Familial segregation of the nonsense variant in ZPBP revealed two fertile brothers and the patient's mother to be heterozygous carriers. Paternal DNA was unavailable. Immunohistochemistry confirmed that ZPBP localises to the acrosome in human spermatozoa. Ultrastructural analysis of spermatozoa in the patient with the C7orf61 mutation revealed a mixture of round heads with no acrosomes (globozoospermia) and ovoid or irregular heads with small acrosomes frequently detached from the sperm head (acrosomal hypoplasia). LIMITATIONS, REASONS FOR CAUTION: Stringent filtering criteria were used in the exome data analysis which could result in possible pathogenic variants remaining undetected. Additionally, functional follow-up is needed for several candidate genes to confirm the impact of these mutations on normal spermatogenesis. WIDER IMPLICATIONS OF THE FINDINGS: Our study revealed an important role for mutations in ZPBP and CCDC62 in human globozoospermia as well as five new candidate genes. These findings provide a more comprehensive understanding of the genetics of male infertility and bring us closer to a complete molecular diagnosis for globozoospermia patients which would help to predict the success of reproductive treatments. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by The Netherlands Organisation for Scientific Research (918-15-667); National Health and Medical Research Council of Australia (APP1120356) and the National Council for Scientific Research (CONICET), Argentina, PIP grant 11220120100279CO. The authors have nothing to disclose.

The effects of radiofrequency electromagnetic radiation on sperm function.

Mobile phone usage has become an integral part of our lives. However, the effects of the radiofrequency electromagnetic radiation (RF-EMR) emitted by these devices on biological systems and specifically the reproductive systems are currently under active debate. A fundamental hindrance to the current debate is that there is no clear mechanism of how such non-ionising radiation influences biological systems. Therefore, we explored the documented impacts of RF-EMR on the male reproductive system and considered any common observations that could provide insights on a potential mechanism. Among a total of 27 studies investigating the effects of RF-EMR on the male reproductive system, negative consequences of exposure were reported in 21. Within these 21 studies, 11 of the 15 that investigated sperm motility reported significant declines, 7 of 7 that measured the production of reactive oxygen species (ROS) documented elevated levels and 4 of 5 studies that probed for DNA damage highlighted increased damage due to RF-EMR exposure. Associated with this, RF-EMR treatment reduced the antioxidant levels in 6 of 6 studies that discussed this phenomenon, whereas consequences of RF-EMR were successfully ameliorated with the supplementation of antioxidants in all 3 studies that carried out these experiments. In light of this, we envisage a two-step mechanism whereby RF-EMR is able to induce mitochondrial dysfunction leading to elevated ROS production. A continued focus on research, which aims to shed light on the biological effects of RF-EMR will allow us to test and assess this proposed mechanism in a variety of cell types.

Human spermatozoa possess an IL4I1 l-amino acid oxidase with a potential role in sperm function.

Reactive oxygen species (ROS) are known to play an important role in the regulation of human sperm function. In this study, we demonstrate for the first time that human spermatozoa possess interleukin-induced gene 1 (IL4I1), an l-amino acid oxidase (LAAO) which is capable of generating ROS on exposure to aromatic amino acids in the presence of oxygen. The preferred substrates were found to be phenylalanine and tryptophan while the enzyme was located in the acrosomal region and midpiece of these cells. In contrast to equine and bovine spermatozoa, enzyme activity was lost as soon as the spermatozoa became non-viable. On a cell-to-cell basis human spermatozoa were also shown to generate lower levels of hydrogen peroxide than their equine counterparts on exposure to phenylalanine. Stimulation of LAAO activity resulted in the induction of several hallmarks of capacitation including tyrosine phosphorylation of the sperm flagellum and concomitant activation of phospho-SRC expression. In addition, stimulation of LAAO resulted in an increase in the levels of acrosomal exocytosis in both the presence and absence of progesterone stimulation, via mechanisms that could be significantly reversed by the presence of catalase. As is often the case with free radical-mediated phenomena, prolonged exposure of human spermatozoa to phenylalanine resulted in the stimulation of apoptosis as indicated by significant increases in mitochondrial superoxide generation and the activation of intracellular caspases. These results confirm the existence of an LAAO in human spermatozoa with a potential role in driving the redox regulation of sperm capacitation and acrosomal exocytosis.

Compact directional acoustic sensor using a multi-fiber optical probe.

A compact directional acoustic sensor is described which uses a two-fiber optical probe, a light emitting diode (LED), a photo-diode detector, and a slender cylindrical cantilever to the end of which is attached an optical reflector. Acoustically induced transverse displacement of the cantilever tip modulates the light reflected by it into the collection fiber, which conveys the light to a photo-detector. Directional sensitivity is achieved through the dependence of the collected light on the cosine of the angle between a line through the centers of the two fibers and the cantilever tip displacement (the sound direction). The sensor requires relatively low power, and its LED source has low levels of 1/f noise. These attributes make it a good choice for remote low frequency applications requiring long operating lifetimes. An analytic model of the acoustic response of the cantilever is constructed, which is partially verified using a finite element model and experimentally validated using measurements of the acoustic response in air. The model is used to predict to what extent and over what frequency band that response depends upon the acoustically generated flow (drag) force [Yuan et al., IEEE Sensor J. 8, 1114-1117 (2008)].

Bistatic, above-critical angle scattering measurements of fully buried unexploded ordnance (UXO) and clutter.

Laboratory grade bistatic scattering measurements are conducted in order to examine the acoustic response of realistic fully buried unexploded ordnance (UXO) from above-critical angle insonification, between 2 and 40 kHz. A 127 mm diameter rocket UXO, a 155 mm diameter artillery shell, a natural rock of approximately the same size, and a cinder block are fully buried in water-saturated medium grained sand (mean grain diameter, 240 µm) at depths of 10 cm below the water-sediment interface. A two-dimensional array of bistatic scattering measurements is generated synthetically by scanning a single hydrophone in steps of 3 cm over a 1 m × 1 m patch directly above the targets at a height of 20 cm above the water-sediment interface. Three-dimensional volumetric acoustic images generated from the return waveforms reveal scattering components attributed to geometric and elastic scattering, as well as multiple-scattering interactions of returns between the sediment-water interface and the buried objects. The far-field target strength of the objects is estimated through extrapolation of the angular spectrum. Agreement is found between experimental data and simulated data generated from a finite-element-based, three-dimensional time-harmonic model (2-25 kHz). Separation of the measured UXO from the clutter objects is demonstrated through exploitation of structural-acoustics-based features.

Refinement of the hereditary xerocytosis locus on chromosome 16q in a large Canadian kindred.

The hereditary stomatocytoses are a group of heterogeneous conditions associated with chronic red cell hemolysis for which the causative genetic mutations are not known. We investigated 137 members of a large Canadian kindred with phenotypic findings consistent with hereditary xerocytosis, one of the most common stomatocytosis syndromes. The objectives of this study were to characterize the clinical hallmarks of the hemolytic process, and to define the chromosomal region carrying the disease locus. The mode of inheritance was autosomal dominant. Affected family members had a well-compensated hemolysis, associated with an elevated MCHC, decreased osmotic fragility, decreased haptoglobin, and indirect hyperbilirubinemia. Cholelithiasis and progressive iron loading were common, despite normal hemoglobin levels. Quantitative erythrocyte morphologic evaluation revealed increased schistocytes, target cells, reticulocytes, and eccentrocytes in affected individuals; stomatocytes were not increased. Genetic linkage analysis confirmed the localization of the disease phenotype to chromosome 16q, and refined the candidate region to 16q24.2-16qter, a 2.4 million base pair interval containing 51 known or predicted genes.

Forward scatter target strength extraction in a marine environment (L).

A 48 m rail with a moving receiver was used to measure forward scattering from a spherical shell lying on the bottom in the Gulf of Mexico. The target was mid-way between the source and rail, on a line from the source bisecting the rail. The major obstacle to the measurement of forward scattering is the much stronger source signal which overlaps the scattered signal in space and time. Here, forward scattered target strength is obtained by processing the received signals using a wavenumber filter to remove the incident wave. The result compares favorably to that obtained from numerical predictions.

Structural-acoustic modeling for three-dimensional freefield and littoral environments with verification and validation.

This paper describes a high-order, finite-element-based, three-dimensional time-harmonic model for large-scale exterior structural-acoustics problems. It is applicable to both freefield and littoral environments. For the freefield case, the infinite exterior is treated as a homogeneous linear acoustic medium. For littoral applications, the water or air and the sediment domains are each treated as linear homogeneous, semi-infinite half-spaces with piecewise-constant properties. Both domains admit complex-valued wave speeds to enable the inclusion of damping. The finite element formulation uses a variational statement which naturally incorporates the transmission-condition at the water or air-sediment interface. The truncation of the infinite exterior is realized using an infinite-element for the freefield case, and the perfectly-matched-layer approximation for littoral applications. Computation of the farfield quantities is done based on an integral representation which, for the littoral cases, uses efficient approximations for the appropriate Green's function. Numerical computations are presented for a series of progressively more complex problems, and are used to verify the model against analytic and other numerical solutions and validate it based on the experimental data for scattering from elastic scatterers as measured in freefield and sediment pool laboratory facilities.

Exploiting forward scattering for detecting submerged proud/half-buried unexploded ordnance.

Laboratory underwater bistatic scattering measurements are reported for free, proud, and half-buried unexploded ordnances for 0 degrees and 90 degrees source angles. Forward echoes are larger than backscattered returns, and half burial significantly decreases the latter but not the former. Results agree with analytic predictions borrowed from radar. The forward echo and source signal are separated by measurements made with and without the target, a method not possible in a target search. For this, a method is described that uses knowledge of the source location and the hyperbolic character in time-cross range of the signals received at points along a line.

Bistatic scattering from submerged unexploded ordnance lying on a sediment.

The broadband bistatic target strengths (TSs) of two submerged unexploded ordnance (UXO) targets have been measured in the NRL sediment pool facility. The targets-a 5 in. rocket and a 155 mm projectile-were among the targets whose monostatic TSs were measured and reported previously by the authors. Bistatic TS measurements were made for 0 degrees (target front) and 90 degrees (target side) incident source directions, and include both backscattered and forward scattered echo angles over a complete 360 degrees with the targets placed proud of the sediment surface. For the two source angles used, each target exhibits two strong highlights: a backscattered specular-like echo and a forward scattered response. The TS levels of the former are shown to agree reasonably well with predictions, based on scattering from rigid disks and cylinders, while the levels of the latter with predictions from radar cross section models, based on simple geometric optics appropriately modified. The bistatic TS levels observed for the proud case provide comparable or higher levels of broadband TS relative to free-field monostatic measurements. It is concluded that access to bistatic echo information in operations aimed at detecting submerged UXO targets could provide an important capability.

A numerical study of defect detection in a plaster dome ceiling using structural acoustics.

A numerical study is carried out to evaluate the effectiveness of using measured surface displacements resulting from acoustic speaker excitation to detect and localize flaws in a domed, plaster ceiling. The response of the structure to an incident acoustic pressure is obtained at four frequencies between 100 and 400 Hz using a parallel h-p structural acoustic finite element-based code. Three ceiling conditions are modeled: the pristine ceiling considered rigidly attached to the domed-shape support, partial detachment of a segment of the plaster layer from the support, and an interior pocket of plaster deconsolidation modeled as a heavy fluid. Spatial maps of the normal displacement resulting from speaker excitation are interpreted with the help of predictions based on static analysis. It is found that acoustic speaker excitation can provide displacement levels readily detected by commercially available laser Doppler vibrometer systems. Further, it is concluded that for 1 in. thick plaster layers, detachment sizes as small as 4 cm are detectable by direct observation of the measured displacement maps. Finally, spatial structure differences are observed in the displacement maps beneath the two defect types, which may provide a wavenumber-based feature useful for distinguishing plaster detachment from other defects such as deconsolidation.

Conformal Fourier wavenumber decompositions on continuous differentiable surfaces.

In this manuscript, a method is introduced for the evaluation of Fourier wavenumber decompositions on C(1) vibrating surfaces for spatial-spectral analysis. Whereas typical Fourier analysis is restricted to geometries that are separable for meaningful interpretations of the corresponding wave motion, this approach allows for conformal spectral analysis along curved surfaces. This is accomplished by restricting the wavevectors to lie within the local tangent to the surface and to be spatially dependent. The theoretical development is presented and it is demonstrated that commonly utilized kernels appropriate for some simple geometries can be recovered. Additionally, this approach is applied in the analysis of the vibration and radiation of a point driven, fluid loaded cone, where the displacements and pressures have been obtained using the finite element method.

Broadband acoustic scattering measurements of underwater unexploded ordnance (UXO).

In order to evaluate the potential for detection and identification of underwater unexploded ordnance (UXO) by exploiting their structural acoustic response, we carried out broadband monostatic scattering measurements over a full 360 degrees on UXO's (two mortar rounds, an artillery shell, and a rocket warhead) and false targets (a cinder block and a large rock). The measurement band, 1-140 kHz, includes a low frequency structural acoustics region in which the wavelengths are comparable to or larger than the target characteristic dimensions. In general, there are aspects that provide relatively high target strength levels ( approximately -10 to -15 dB), and from our experience the targets should be detectable in this structural acoustics band in most acoustic environments. The rigid body scattering was also calculated for one UXO in order to highlight the measured scattering features involving elastic responses. The broadband scattering data should be able to support feature-based separation of UXO versus false targets and identification of various classes of UXO as well.

Chromosomal localization of the chicken and mammalian orthologues of the orphan phosphatase PHOSPHO1 gene.

PHOSPHO1 is a recently identified phosphatase expressed at high levels in the chicken growth plate and which may be involved in generating inorganic phosphate for skeletal matrix mineralization. Using a degenerate RT-PCR approach a fragment of human PHOSPHO1 was cloned. This enabled the identification of the human orthologue on HSA17q21, and the mouse orthologue on a region of MMU11 that exhibits conservation of synteny with HSA17q21. Chicken PHOSPHO1 was mapped by SSCP analysis to position 44 cM on GGA27, adjacent to the HOXB@ (44 cM) and COL1A1 (36 cM) loci. Comparison of genes on GGA27 with their orthologues on the preliminary draft of the human genome identifies regions of conserved synteny equivalent to 25 Mb on HSA17q21.2-23.3 and approximately 20 Mb on GGA27 in which the gene order appears to be conserved. Mapping of the PHOSPHO1 genes to regions of HSA17q21.3, MMU11 and GGA27 that exhibit conservation of synteny provides strong evidence that they are orthologous.

Unusual cerebellar ataxia: "worm wobble" revisited.

We present an unusual case of cerebellar ataxia in a 2 year old girl several days after treatment with piperazine citrate for suspected worm infestation. This is the first reported case of delayed onset neurotoxicity following the therapeutic administration of piperazine in a previously well child.

Regulation of chondrocyte terminal differentiation in the postembryonic growth plate: the role of the PTHrP-Indian hedgehog axis.

Chondrocyte differentiation during embryonic bone growth is controlled by interactions between PTHrP and Indian hedgehog. We have now determined that the major components of this signaling pathway are present in the postembryonic growth plate. PTHrP was immunolocalized throughout the growth plate, and semiquantitative RT-PCR analysis of maturationally distinct chondrocyte fractions indicated that PTHrP, Indian hedgehog, and the PTH/PTHrP receptor were expressed at similar levels throughout the growth plate. However, patched, the hedgehog receptor, was more highly expressed in proliferating chondrocytes. Although all fractionated cells responded to PTHrP in culture by increasing thymidine incorporation and cAMP production and decreasing alkaline phosphatase activity, the magnitude of response was greatest in the proliferative chondrocytes. Bone morphogenetic proteins are considered likely intermediates in PTHrP signaling. Expression of bone morphogenetic protein-2 and 4--7 was detected within the growth plate, and PTHrP inhibited the expression of bone morphogenetic protein-4 and 6. Although organ culture studies indicated a possible paracrine role for epiphyseal chondrocyte-derived PTHrP in regulating growth plate chondrocyte differentiation, the presence within the postembryonic growth plate of functional components of the PTHrP-Indian hedgehog pathway suggests that local mechanisms intrinsic to the growth plate exist to control the rate of endochondral ossification.